Favourable neurological outcome following paediatric out-of-hospital cardiac arrest: a retrospective observational study

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine resuscitation and emergency medicine, 2023-12, Vol.31 (1), p.106-106, Article 106
• Main Authors: Fuchs, Alexander, Bockemuehl, Deliah, Jegerlehner, Sabrina, Both, Christian P, Cools, Evelien, Riva, Thomas, Albrecht, Roland, Greif, Robert, Mueller, Martin, Pietsch, Urs
• Format: Article
• Language: English
• Subjects: Advanced life support; Age; Cardiac arrest; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Care and treatment; Chain-of-survival; Child; Children; CPR; Emergency medical care; Emergency Medical Services; Emergency Responders; Emergency services; Etiology; Helicopter ambulances; Helicopters; HEMS; Hospitals; Humans; Male; Missing data; Observational studies; Original Research; Out-of-hospital Cardiac Arrest; Out-of-Hospital Cardiac Arrest - etiology; Out-of-Hospital Cardiac Arrest - therapy; Paramedics; Patient outcomes; Patients; Pediatric emergencies; Pediatric research; Pediatrics; Registries; Resuscitation; Retrospective Studies; Statistics
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/s13049-023-01165-y

Out-of-hospital cardiac arrest (OHCA) in children is rare and can potentially result in severe neurological impairment. Our study aimed to identify characteristics of and factors associated with favourable neurological outcome following the resuscitation of children by the Swiss helicopter emergency medical service. This retrospective observational study screened the Swiss Air-Ambulance electronic database from 01-01-2011 to 31-12-2021. We included all primary missions for patients ≤ 16 years with OHCA. The primary outcome was favourable neurological outcome after 30 days (cerebral performance categories (CPC) 1 and 2). Multivariable linear regression identified potential factors associated with favourable outcome (odd ratio - OR). Having screened 110,331 missions, we identified 296 children with OHCA, which we included in the analysis. Patients were 5.0 [1.0; 12.0] years old and 61.5% (n = 182) male. More than two-thirds had a non-traumatic OHCA (67.2%, n = 199), while 32.8% (n = 97) had a traumatic OHCA. Thirty days after the event, 24.0% (n = 71) of patients were alive, 18.9% (n = 56) with a favourable neurological outcome (CPC 1 n = 46, CPC 2 n = 10). Bystander cardiopulmonary resuscitation (OR 10.34; 95%CI 2.29-51.42; p = 0.002) and non-traumatic aetiology (OR 11.07 2.38-51.42; p = 0.002) were the factors most strongly associated with favourable outcome. Factors associated with an unfavourable neurological outcome were initial asystole (OR 0.12; 95%CI 0.04-0.39; p